Individual
AZEB LEMMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1100 REID PKWY, SUITE 105, RICHMOND, IN 47374-1157
(765) 935-8773
(765) 935-8774
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 935-8773
(765) 935-8774
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71006213A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001012321
ANTHEM
IN
05
—
0166922
—
OH
05
—
201355000
—
IN
Enumeration date
03/22/2016
Last updated
05/17/2021
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